Abstract: Cerrado is the second largest biome in Brazil and majorly contributes to the country's grain production. Previous studies on soil metagenomics from the Cerrado revealed an outstanding microbial diversity. In this study, the abundance of pathogenic fungi was analyzed using metagenomic sequences of the Cerrado soils under native vegetation, and under agriculture with no-tillage and conventional tillage. In total, 128,627 sequences of fungi were identified, with 43,439 representing pathogenic fungi and were distributed as follows: native 17,301 (40%), no-tillage 13,780 (32%), and conventional tillage 12,358 (28%). We identified 41 pathogenic fungal species associated with human and animal infections. The data analysis revealed that the native soils had a higher relative abundance of fungal sequences, similar to pathogenic species sequences, in relation to the total eukaryotic sequences, than the conventional tillage and no-tillage treatments, which observed a reduction in fungal abundance because of anthropogenic activities.

ABSTRACT Cryptosporidiosis is a disease caused by the Cryptosporidium spp parasite. As some species of Cryptosporidium have a wide host spectrum, the characterization of the pathogen at the species or genotype level is of great importance to define the sources of infection for humans and the potential for public health. This study investigated the diversity of the genus Cryptosporidium spp. in humans from all over the American continent and observed whether the method used to search for the parasite influenced the prevalence found in the Americas. This systematic review was carried out using the Pubmed, Science direct, Lilacs, Scielo, and Scopus databases with publications from January 1, 2010, to December 31, 2020. For data synthesis, the PRISMA flowchart was used and for the meta-analysis we used the MetaXL program. Of the selected publications, 57, 9 and 16 belonged to the region of South, Central and North America, respectively. The prevalence found for South, Central, and North America was 7%, 7%, and 8%, respectively, when analyzing publications that used only the microscopy method. When we analyzed the publications that used immunological and molecular methods, we found prevalences of 10%, 9%, and 21% for South, Central, and North America, respectively. The C. hominis subtype IbA10G2 was the most reported in the American continent, followed by subtype IeA11G3T3 and, for C. parvum, subtype IIaA15G2RI was the most reported. In conclusion, Cryptosporidium spp. is present throughout the American continent and its prevalence is higher when immunological and/or molecular methods are used, in addition to direct microscopic examination.

Abstract INTRODUCTION: Cerebrospinal fluid analysis contributes to the diagnosis and neuropathogenesis of neuroinvasive arboviruses. Neurological complications caused by dengue, Zika, and chikungunya infections have high clinical relevance because of their high potential to cause death or neurological deficits. We aimed to evaluate the use of cerebrospinal fluid assays for diagnostic support in neurological disorders associated with dengue, chikungunya, and Zika infections. METHODS: A systematic review was carried out by searching the electronic databases LILACS, PubMed, Scopus, and Embase for articles written in English, Portuguese, or Spanish in the last 19 years. Published studies were reviewed using the terms “dengue,” “Zika”, “chikungunya”, alone or in combination with “cerebrospinal fluid” in the period from 2000 to 2019. RESULTS: A total of 98,060 studies were identified; of these, 1.1% (1,041 studies, 58,478 cases) used cerebrospinal fluid assays for neurological investigations. The most frequent neurological disorders included encephalitis (41.4%), congenital syndromes (17%), and microcephaly associated with Zika virus infections (8.9%). Neuroinvasive disorders were confirmed in 8.03% of 58,478 cases by specific cerebrospinal fluid analyses. The main methods used were IgM-specific antibodies (66%) and reverse transcription-polymerase chain reaction (10%). The largest number of scientific papers (29%) originated from Brazil, followed by India (18.4%) and the United States (14.4%). CONCLUSIONS: Although cerebrospinal fluid analysis is of great importance for increasing neurological diagnostic accuracy and contributes to the early diagnosis of neuroinvasive dengue, chikungunya, and Zika infections, it is underused in routine laboratory investigations worldwide.

Background: Aiming to facilitate the drug dispensing process and patient counseling, specific professional skills are required. The knowledge, skills and attitudes involved in this process can be improved. From 2012 to 2015, a nationwide course was held, in partnership with the Ministry of Health and the Federal University of Rio Grande do Sul (UFRGS) - Brazil, to train pharmacists working in primary health care through the development of their clinical and communication skills. One of the steps in this process involved the simulation of the drug dispensing process and patient counseling. Objective: To evaluate the performance of pharmacists in drug dispensing and counseling through patient simulation role-playing held in a face-to-face meeting at the end of a training course. Methods: A cross-sectional and retrospective study with analysis of patient simulation recordings and data collection using an assessment instrument with scores ranging from 0 to 10 points to assess pharmacist's behavior, skills, and technical knowledge. Results: Participants presented poor-to-regular performance, with median scores equal to or lower than six. The median time of the drug dispensing simulation was five minutes and the patient counseling was eight minutes. Pharmacists had better scores in the simulation of asthma cases. In drug dispensing, 99.5% of pharmacists had difficulty checking the patient's time availability, 98.5% did not know how to use the devices, and 94.7% did not advise the patient on what to do if they forgot to take a dose. In patient counseling simulation, 1.18% of pharmacists remembered to advise on what do with medication leftovers, and 50.6% asked questions that induced the patient's responses. Conclusions: The low-to-regular performance showed that pharmacists had difficulties at improving their skills in the performance of complete and effective drug dispensing and patient counseling.

Resumo O vírus herpes simples (HSV) é um dos agentes causadores de uma doença grave no sistema nervoso central (SNC) em humanos. A detecção de anticorpos específicos no líquido cefalorraquidiano (LCR) pode contribuir para o diagnóstico neurológico retrospectivo. Entretanto, os testes imunológicos comerciais são para uso em amostras de soro. Objetivo: Adaptar um kit comercial sorológico anti-HSV IgG para ser utilizado no de LCR. Metodos: Quarenta amostras de LCR de 38 pacientes com suspeita de infecção por HSV no SNC foram diluídas pesquisa de anticorpos anti-HSV IgG pelo método imunoenzimático (EIA). Além disso, as mesmas amostras também foram analisadas por reação em cadeia da polimerase (PCR). Resultados: A sensibilidade do teste EIA para o HSV consistiu em 5% (diluição 1:40) e 65% (diluição 1:2) no LCR, e o PCR do DNA do HSV, 15%. A análise combinada de EIA (diluição 1:2) e PCR aumentou a sensibilidade para 72,5%. Houve associação entre presença do LCR inflamatório e PCR positiva para HSV. Conclusões: Demonstramos a importância na adaptação previa do teste sorológico anti-HSV IgG EIA para ensaios do no LCR, a fim de aumentar a acuracia da análise, considerando a baixa concentração de anticorpos específicos no LCR.

Abstract Herpes simplex virus (HSV) is a cause of a severe disease of the central nervous system (CNS) in humans. The demonstration of specific antibodies in the cerebrospinal fluid (CSF) may contribute to the retrospective neurological diagnosis. However, the commercial immunological tests for HSV infection are for use in serum samples. Objective: The aim of the present study was to adapt a commercial kit anti-HSV IgG used for serum samples to be performed with a CSF sample. Methods: Forty CSF specimens from 38 patients with suspected CNS HSV infection were serially diluted for detecting anti-HSV IgG by enzyme immunoassay (EIA). The same samples were also analyzed with the polymerase chain reaction (PCR). Results: The sensitivity of EIA test for HSV was 5% (dilution 1:40) and 65% (dilution 1:2) in CSF, and HSV DNA PCR was 15%. The combined analysis of EIA (dilution 1:2) and PCR increased the sensitivity up to 72.5%. The inflammatory CSF was associated with positive HSV PCR. Conclusions: We demonstrated the importance to adapt serological anti-HSV IgG EIA test for CSF assays to increase the accuracy of the analysis, considering the low concentration of specific antibodies in CSF.

RESUMO A sífilis é uma infecção reemergente sexualmente transmissível pelo espiroqueta Treponema pallidum, que pode penetrar precocemente no sistema nervoso central. O teste venereal disease research laboratory test (VDRL) no líquido cefalorraquidiano (LCR) é o mais amplamente utilizado para diagnóstico de neurossífilis. Avalia-se o desempenho de dois outros testes não treponêmicos (rapid plasma reagin - RPR and unheated serum reagin - USR tests) em comparação ao VDRL no LCR. Métodos: Foram analisadas amostras de LCR de 120 indivíduos com base no quadro clínico compatível com neurossifilis e reatividade no VDRL no LCR. Resultados: Os testes apresentaram elevada concordância. O coeficiente de correlação intraclasse para concordância absoluta foi de 1 para VDRL versus USR, 0,99 para VDRL versus RPR e 0,99 para RPR versus USR. Conclusões: Os testes rapid plasma reagin e unheated serum reagin foram identificados como excelentes alternativas para o diagnóstico de neurossífilis.

ABSTRACT Syphilis is a re-emerging sexually-transmitted infection, caused by the spirochete Treponema pallidum, that may penetrate early into the central nervous system. The venereal disease research laboratory test (VDRL) on the cerebrospinal fluid (CSF) is the most widely used for neurosyphilis diagnosis. We evaluated the performance of two other nontreponemal tests (rapid plasma reagin [RPR] and unheated serum reagin [USR] tests) in comparison with the VDRL in CSF. Methods: We analyzed CSF samples from 120 individuals based on VDRL reactivity in the CSF and the clinical picture of neurosyphilis. Results: High inter-rater reliability was found among all three tests, with equivalent sensitivity and specificity. Intraclass correlation coefficient for absolute agreement was 1 for VDRL versus USR, 0.99 for VDRL versus RPR, and 0.99 for RPR versus USR. Conclusions: Rapid plasma reagin and unheated serum reagin tests were identified as excellent alternatives for neurosyphilis diagnosis.

Resumo O objetivo deste artigo é investigar as morbidades relacionadas a medicamentos (MRM), os fatores e as causas detectados em pacientes que buscam o serviço de emergência de hospital universitário do sul do Brasil. A coleta de dados baseou-se na aplicação de um questionário aos pacientes com idade mínima de 18 anos, durante o período de outubro de 2013 a março de 2014, e na análise do prontuário eletrônico. Os casos foram avaliados para definir se era um caso de MRM e para estabelecer as suas possíveis causas. A evitabilidade da MRM foi verificada com base em critérios previamente estabelecidos na literatura. No total foram entrevistados 535 pacientes e a frequência de MRM foi de 14,6%. Aproximadamente, 45% das MRMs foram relacionadas com a segurança no uso de medicamentos e cerca de 50% apresentou como possível causa questões relacionadas ao usuário. Houve necessidade de internação em 44,8% dos casos de MRM; 62,7% dos casos foram considerados evitáveis. Presença de doença crônica e utilização de medicamentos potencialmente perigosos e de baixo índice terapêutico foram consideradas fatores associados ao desenvolvimento de MRM.

Abstract This article aims to investigate the morbidities related to medications, their risk factors and causes detected in patients who seek the Hospital Emergency Service of a University in the South of Brazil. Data collection was based on application of a questionnaire to patients of a minimum age of 18 years, that signing the Term of Free and Informed Consent (TFIC), during the period from October 2013 to March 2014, and analysis of electronic record charts. Cases were evaluated by pharmacists and a doctor to define whether it was a case of medication related morbidity (MRM) and to establish its possible causes. Avoidability of MRM was verified based on criteria previously established in the literature. In total 535 patients were interviewed, and the frequency of MRM was 14.6%, Approximately 45% of MRMs were related to safety in the use of medications, and approximately 50% presented user-related questions as the possible cause. Hospitalization was required in 44.8% of MRM cases; 62.7% of cases were considered avoidable. Presence of chronic disease and use of potentially dangerous medication and low therapeutic index were considered independent factors associated with development of MRM, according to statistical analysis.

Resumo O objetivo deste artigo é investigar as morbidades relacionadas a medicamentos (MRM), os fatores e as causas detectados em pacientes que buscam o serviço de emergência de hospital universitário do sul do Brasil. A coleta de dados baseou-se na aplicação de um questionário aos pacientes com idade mínima de 18 anos, durante o período de outubro de 2013 a março de 2014, e na análise do prontuário eletrônico. Os casos foram avaliados para definir se era um caso de MRM e para estabelecer as suas possíveis causas. A evitabilidade da MRM foi verificada com base em critérios previamente estabelecidos na literatura. No total foram entrevistados 535 pacientes e a frequência de MRM foi de 14,6%. Aproximadamente, 45% das MRMs foram relacionadas com a segurança no uso de medicamentos e cerca de 50% apresentou como possível causa questões relacionadas ao usuário. Houve necessidade de internação em 44,8% dos casos de MRM; 62,7% dos casos foram considerados evitáveis. Presença de doença crônica e utilização de medicamentos potencialmente perigosos e de baixo índice terapêutico foram consideradas fatores associados ao desenvolvimento de MRM.

Abstract This article aims to investigate the morbidities related to medications, their risk factors and causes detected in patients who seek the Hospital Emergency Service of a University in the South of Brazil. Data collection was based on application of a questionnaire to patients of a minimum age of 18 years, that signing the Term of Free and Informed Consent (TFIC), during the period from October 2013 to March 2014, and analysis of electronic record charts. Cases were evaluated by pharmacists and a doctor to define whether it was a case of medication related morbidity (MRM) and to establish its possible causes. Avoidability of MRM was verified based on criteria previously established in the literature. In total 535 patients were interviewed, and the frequency of MRM was 14.6%, Approximately 45% of MRMs were related to safety in the use of medications, and approximately 50% presented user-related questions as the possible cause. Hospitalization was required in 44.8% of MRM cases; 62.7% of cases were considered avoidable. Presence of chronic disease and use of potentially dangerous medication and low therapeutic index were considered independent factors associated with development of MRM, according to statistical analysis.

Background: Cyclosporine and tacrolimus are limited by a narrow therapeutic window. Maintaining immunosuppressive drugs at desired levels may be difficult. Pharmaceutical care emerges as a philosophy of practice that enhances medication use and leads to a better control of serum concentration. Objective: This study aims to evaluate the impact of pharmaceutical care in the maintaining of proper serum levels of immunosuppressive medications in patients who have undergone allo-HSCT. Methods: The study had a quasi-experimental design that included a comparison group. The service model used was pharmacotherapy follow-up, according to an adaptation of the Dader method. The pharmacist consultation was carried out at a day-hospital or at the outpatient hematology clinic as needed. The intervention group consisted of 22 patients seen by a clinical pharmacist. The control group consisted of 44 patients that received standard care. This study aims to evaluate the impact of pharmaceutical care on keeping patient serum levels of cyclosporine and tacrolimus within the desired range. Results: Control group displayed 65% of the proper serum levels of immunosuppressive agents. While In intervention group, the figure was 82% (p = 0.004). Conclusion: The role of the pharmacist in the multidisciplinary team may contribute to a greater success in attaining the patients' therapeutic targets with regard to the use of immunosuppressant.

A dengue é um importante problema de saúde pública. A Organização Mundial de Saúde estima que 2/5 da população mundial encontra-se em risco de desenvolver a infecção. Cerca de 50 milhões de casos ocorrem anualmente, com ao menos 20 mil mortes. O agente etiológico desta doença febril aguda é um vírus RNA, do gênero Flavivirus. Este arbovírus é transmitido pelo mosquito Aedes sp. A maioria dos indivíduos infectados apresenta infecção assintomática, porém alguns desenvolvem sintomas clínicos. Estes manifestações podem variar desde uma doença inaparente, branda, conhecida como febre da dengue, até uma forma severa, sendo fatal em alguns casos como na febre hemorrágica da dengue/síndrome de choque da dengue. Atualmente, manifestações neurológicas associadas à dengue são cada vez mais frequentes, tornando-se um desafio na rotina médica. Neste estudo, as complicações neurológicas da dengue serão revisadas, com ênfase na melhor compreensão acerca da doença para a prática clínica.

Dengue is an important global public health problem. The World Health Organization estimates that 2/5 of entire world population are in risk of dengue infection. Almost 50 millions cases occur annually, with at least 20 thousand deaths. The etiological agent of this acute febrile disease is a single-strand positive-sense RNA virus of Flavivirus genus. It is an arboviral disease transmitted by Aedes sp. mosquitoes (Aedes aegypti and A. albopictus). Most infected individuals present asymptomatic infection, but some may develop clinical signs. Therefore, a wide spectrum of illness can be observed, ranging from unapparent, mild disease, called dengue fever, to a severe and occasionally fatal dengue hemorrhagic fever/dengue shock syndrome. Currently, neurological manifestations related to dengue infections are increasingly been observed and appears as a challenge for medical practice. In this study the neurological complications of dengue infection will be reviewed, focusing a better understanding of the disease for the clinical practice.

OBJETIVO: Analisar a associação entre aspectos clínicos, lesões de substância branca e reação inflamatória aguda no líquido cefalorraquidiano (LCR) na mielopatia associa ao HTLV-1 (HAM/TSP). MÉTODO: Foram estudadas ressonâncias magnéticas (RM) do encéfalo/medula espinhal cervical e exame do LCR de 28 pacientes com HAM/TSP. RESULTADOS: A maioria dos pacientes apresentava grave incapacidade neurológica, com EDSS 6,5 (3-8). A RM revelou lesões da substância branca (75%) com predominância periventricular e atrofia cortical (14%). Lesões desmielinizantes cervicais ocorreram em 11% dos casos e atrofia em 3,5%. Um paciente apresentou lesão cervical na T1 com captação de contraste. Sinais de inflamação aguda no LCR ocorreram em situações de lesão da medula espinhal cervical. As alterações de substância branca do encéfalo predominaram nos indivíduos com maior faixa etária. CONCLUSÃO: Nossos achados sugerem que processo inflamatório com atividade clínica na HAM/TSP está associado a lesões da medula espinhal cervical. As anormalidades da substância branca encefálicas não são relacionadas ao quadro clínico de HAM/TSP.

OBJECTIVE: To investigate the association between clinical data, white matter lesions and inflammatory cerebrospinal fluid (CSF) findings in HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). METHOD: We studied brain and cervical spinal cord on magnetic resonance imaging (MRI) and CSF examinations of 28 Brazilian HAM/TSP patients. RESULTS: The majority of patients had severe neurological incapacity with EDSS median of 6.5 (3-8). The brain MRI showed white matter lesions (75%) and atrophy (14%). The preferential brain location was periventricular. Cervical demyelination lesions occurred in 11% of the cases, and cervical atrophy in 3.5%. One patient had enhancement lesions on T1 cervical spinal cord MRI. Cases with spinal cord lesions had signs of acute CSF inflammation. The brain white matter lesions predominated in the patients with higher age. CONCLUSION: Our data suggest that an active inflammatory process is associated with the cervical spinal cord lesions in HAM/TSP. The brain abnormalities are not related to the clinical picture of HAM/TSP.

Objective: To assess the frequency and types of drug-related problems (DRPs) in patients seeking emergency care in a teaching hospital in southern Brazil and to identify the possible causes and drugs involved in these problems. Method: A cross-sectional study was performed, using a structured questionnaire for data collection. Multivariate logistic regression was used to control for possible confounding factors and to establish an independent association between the presence of DRPs and the amount of medication, patient's age and their educational level. Results: A total of 350 patients were interviewed. The frequency of DRPs was 31.6%. Quantitative ineffectiveness was observed in 30.9% of DRPs and the main cause of the DRP was an inadequate dosing regimen. Sixty-six DRPs (53.7%) were caused by the health system or the health professionals. Factors independently influencing the development of DRPs were educational level and the number of drugs being taken. Conclusions: Our data suggest that one-third of the patients attending the emergency room of our hospital had a drug-related problem, highlighting the importance of considering drugs as a possible cause of health problems and the need for their more rational use.

Objetivo: Evaluar la frecuencia y el tipo de problemas relacionados con medicamentos que presentan los pacientes que acuden al servicio de urgencias en un hospital universitario del sur de Brasil, e identificar las posibles causas y los fármacos involucrados. Método: La investigación siguió el modelo de estudio transversal, con una encuesta estructurada para la recogida de los datos. Se empleó el análisis de regresión logística múltiple para controlar posibles factores de confusión y establecer una asociación independiente entre la presencia de problemas relacionados con medicamentos y el número de éstos, la edad y el nivel educativo. Resultados: Se entrevistaron 350 pacientes y la frecuencia de problemas relacionados con medicamentos fue del 31,6%. La inefectividad cuantitativa se observó en el 30,9% de los casos. La principal causa de los problemas fue el régimen de dosificación inadecuado. El sistema de salud o los profesionales de la salud se identificaron como responsables en 66 casos (53,7%). El nivel educativo y el número de fármacos contribuyeron de forma independiente a la aparición de los problemas. Conclusión: Los datos sugieren que un tercio de los pacientes que buscan atención en el servicio de urgencias del hospital donde se ha realizado el estudio lo hicieron por problemas relacionados con medicamentos, lo que refuerza la importancia de considerar a los fármacos como una posible causa de problemas de salud y la necesidad de promover un uso más racional de ellos.

Objective: To assess the frequency and types of drug-related problems (DRPs) in patients seeking emergency care in a teaching hospital in southern Brazil and to identify the possible causes and drugs involved in these problems. Method: A cross-sectional study was performed, using a structured questionnaire for data collection. Multivariate logistic regression was used to control for possible confounding factors and to establish an independent association between the presence of DRPs and the amount of medication, patient's age and their educational level. Results: A total of 350 patients were interviewed. The frequency of DRPs was 31.6%. Quantitative ineffectiveness was observed in 30.9% of DRPs and the main cause of the DRP was an inadequate dosing regimen. Sixty-six DRPs (53.7%) were caused by the health system or the health professionals. Factors independently influencing the development of DRPs were educational level and the number of drugs being taken. Conclusions: Our data suggest that one-third of the patients attending the emergency room of our hospital had a drug-related problem, highlighting the importance of considering drugs as a possible cause of health problems and the need for their more rational use.

Objetivo: Evaluar la frecuencia y el tipo de problemas relacionados con medicamentos que presentan los pacientes que acuden al servicio de urgencias en un hospital universitario del sur de Brasil, e identificar las posibles causas y los fármacos involucrados. Método: La investigación siguió el modelo de estudio transversal, con una encuesta estructurada para la recogida de los datos. Se empleó el análisis de regresión logística múltiple para controlar posibles factores de confusión y establecer una asociación independiente entre la presencia de problemas relacionados con medicamentos y el número de éstos, la edad y el nivel educativo. Resultados: Se entrevistaron 350 pacientes y la frecuencia de problemas relacionados con medicamentos fue del 31,6%. La inefectividad cuantitativa se observó en el 30,9% de los casos. La principal causa de los problemas fue el régimen de dosificación inadecuado. El sistema de salud o los profesionales de la salud se identificaron como responsables en 66 casos (53,7%). El nivel educativo y el número de fármacos contribuyeron de forma independiente a la aparición de los problemas. Conclusión: Los datos sugieren que un tercio de los pacientes que buscan atención en el servicio de urgencias del hospital donde se ha realizado el estudio lo hicieron por problemas relacionados con medicamentos, lo que refuerza la importancia de considerar a los fármacos como una posible causa de problemas de salud y la necesidad de promover un uso más racional de ellos.

Nos últimos anos, o uso de testes de exercício é reconhecido como um método conveniente na avaliação da função respiratória em função da necessidade de se conhecer as reservas dos vários sistemas corporais a fim de que uma ideia mais completa sobre as capacidades funcionais do paciente seja obtida. Visto que o ato de andar é uma das principais atividades da vida diária, os testes de caminhada têm sido propostos para medir o estado ou a capacidade funcional do paciente. O teste de caminhada de seis minutos provou ser reprodutível e é bem tolerado pelos pacientes. Ele avalia a distância que uma pessoa pode percorrer sobre uma superfície plana e rígida em seis minutos e tem como principal objetivo a determinação da tolerância ao exercício e da saturação de oxigênio durante um exercício submáximo. Nesta revisão, apresentamos várias áreas clínicas nas quais o teste pode fornecer informações úteis.

Over the last few years, the use of exercise tests has come to be recognized as a convenient method of evaluating respiratory function, because the reserves of the various systems in the human body should be known in order to provide a more complete portrayal of the functional capacities of the patient. Because walking is one of the main activities of daily living, walk tests have been proposed in order to measure the state or the functional capacity of patients. The six-minute walk test has proven to be reproducible and is well tolerated by patients. It evaluates the distance a person can walk on a flat, rigid surface in six minutes. Its main objective is to determine exercise tolerance and oxygen saturation during submaximal exercise. In this review, we present various clinical areas in which the test can provide useful data.

O artigo trata de um estudo empírico em que a análise de redes sociais é utilizada para mapear o capital social de atores envolvidos em processos de governança ambiental na Amazônia brasileira. Por meio de entrevistas, foi mapeada a rede de relações de diálogo sobre questões socioambientais de um conjunto de 505 atores no Território Portal da Amazônia. Foram identificadas 3384 relações de diálogo, com uma média de 6,7 parceiros de diálogo por ator. A análise dos aspectos estruturais da rede de diálogo foi utilizada para construir indicadores de capital social de ligação, com mapeamento da organização interna dos atores de um mesmo município, e de conexão, com a caracterização das relações entre atores de municípios diferentes. Em nível municipal, a distribuição das duas formas de capital social permitiu caracterizar os grupos de atores de acordo com as suas atuações diferenciadas na governança ambiental do Território. Em nível territorial, o padrão de conectividade entre os 16 municípios mostra um equilíbrio entre as duas formas de capital social e revela o potencial de comunicação e organização dos atores, como demonstrado no exemplo dos projetos de Agendas 21 locais. Estes resultados demonstram como a análise de redes sociais pode contribuir na definição (ou redefinição) das fronteiras dos territórios de modo a incluir um conjunto de municípios cujos atores mantêm relações sociais efetivas. Ações de governança no Portal da Amazônia são propostas com potencial para fortalecer os processos de diálogo, diminuir os conflitos e promover o uso sustentável dos recursos naturais na Amazônia.

The article presents an empirical study where social network analysis is used to map social capital among actors involved in environmental governance processes in the Brazilian Amazon. Using interviews, we carried out the mapping of the dialogue network regarding socio-environmental issues among 505 actors from the Amazonian Gateway Territory. The analysis identified 3384 dialogue relationships. Each actor has an average of 6,7 dialogue partners. The analysis of the structural characteristics of the dialogue network was used to build indicators of social capital of the bonding type, based on the mapping of the organization among actors from the same municipalities, and bridging type, based on the identification of relationships among actors from different municipalities. At the municipal level, the distribution of the two types of social capital allowed the characterization of groups of actors according to their differing participation in the environmental governance of the Territory. At the territorial level, the connectivity pattern among the 16 municipalities exhibits a balance between the two types of social capital and reveals the potential of communication and organization among actors, as demonstrated through the example of the local Agenda 21 projects. These results demonstrate how social network analysis can contribute to the definition (or re-definition) of the territories frontiers in order to include a set of municipalities whose cohesion is based on effective social relationships. We also propose governance actions for the Amazonian Gateway aiming at strengthening dialogue processes, reducing conflicts and promoting the sustainable use of natural resources in the Amazon.